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Listening to Diabetes
Using Guided Imagery for Relaxation and Insight

by Susan Shaw, M.S.W., C.Ht.

Lame Deer of the Oglala Sioux is credited with the statement, “What you see with your eyes shut is what counts.” Modern neuroscientists agree. The ability to “see” with the eyes shut, also known as imagery, guided imagery, creative visualization, or active imagination, has become widely accepted as a tool in medicine for managing stress, coping with emotions, and even alleviating physical symptoms.

Commonly offered to cancer patients to improve quality of life during chemotherapy, imagery is also known as a helpful adjunct therapy in preparation for surgery, childbirth, and other difficult situations. It has been shown to provide pain relief, shorten hospital stays, and lessen stress and anxiety. The link between stress and poor blood glucose control in people with diabetes is clearly established. And since much of the professional literature on diabetes calls for approaches to its management that consider the emotional and behavioral — not just physical — needs of the person, an easy-to-use stress buster that can also provide insight into behavior may prove to be very useful. This article provides a brief introduction to guided imagery and outlines three specific exercises that can be performed by individuals, clinicians who work with people with diabetes, or diabetes support groups.

Introductory exercise
Close your eyes for a moment and think of a lemon. Take a couple of deep breaths and relax as you allow the image of a lemon to appear in your mind’s eye. Imagine holding the lemon and feeling its texture, both bumpy and smooth. Use an imaginary magnifying glass to examine its subtleties and colors, even the way light glistens on its surface. Notice the fragrance. Take a knife and cut it open. Taste it if you like, touching it with the tip of your tongue. Is the lemon juicy? What does it smell like? What does it taste like?

Most people will quickly discover that as they become involved with the image, using all of their senses intensely to notice the look, smell, sound, feel, and taste of the lemon, the more engaged the body becomes, and wow, that’s a juicy lemon — sweet, sour, and tart! Feel your saliva flowing as your gums and tongue react to the mere idea of a lemon that isn’t even there. This is the mind–body connection at work, and such interactions between mind and body can become a basis of self-discovery.

Imagery in medicine
Imagery is practiced in an eclectic hodgepodge of forms, some validated by substantial bodies of research, and some not. An upsurge in interest in imagery came in the late 1960’s, when Carl Simonton, MD, developed the use of guided imagery with cancer patients. Evidence was later found that imagery could enhance immune system function and give patients hope and a greater sense of control while coping with a life-threatening disease.

For a 2004 report published in the journal Advances in Mind–Body Medicine, nurses Victoria Menzies and Ann Gill Taylor analyzed 128 clinical studies to form a definition of imagery as a basis for future research. They concluded that “Imagery, a mental function, is a lived experience that is a dynamic, quasi-real, psychophysiological process.” The word “dynamic” refers to the body’s interaction with the brain, which is no longer viewed as a separate, controlling blob that sits on top of the body. Instead, according to neuroscientist Candace Pert, the brain and body together form a psychosomatic network, in which chemical and electrical messages traveling through the bloodstream and nerves carry out several responses — physical, mental, and emotional — simultaneously. Exploring an image and allowing an intense sensory experience to unfold accesses the limbic system, the emotional center of the brain. The limbic system views the imaginary as a real experience, and the brain reacts by sending chemical messages throughout the body via the nervous system.

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